Under the Affordable Care Act (ACA), which resulted in more affordable and accessible preventive care, diagnoses of early-stage colorectal cancer increased among U.S. seniors between 2011 and 2013.

Brett Lissenden and Nengliang “Aaron” Yao published their research in Health Affairs. The authors outlined that during the period of 2007-2010, those with traditional Medical coverage paid all but $275 for a colonoscopy and all but $9 for a mammogram. On average, 14 percent of Medicare patients paid the full remaining cost, while others paid a fraction of it.

In 2011, Medicare implemented these three policies mandated by the ACA that made cancer screening more affordable and accessible, per the authors:

• All cost sharing was waived for routine mammography and initial colorectal cancer screening.
• All cost sharing was waived for one wellness visit per year.
• Physicians who accumulated at least 60 percent of their changes in primary care were awarded a ten percent bonus.

As the program ended in 2015, the researchers also concluded their study in which they used population-based data from the cancer registries of the Surveillance, Epidemiology, and End Results (SEER) Program.

“Our results indicate that the ACA provisions for preventive services in Medicare led to a significant increase in the number of colorectal cancers diagnosed at an early stage. However, we found no evidence that they affected the early diagnosis of breast cancer,” wrote the authors. “A larger reduction in out-of-pocket spending for colorectal cancer screening, compared to breast cancer screening, likely led to a greater increase in the use of colorectal screening.”

With the ACA’s changes to Medicare between 2011 and 2015, there was an increase of about 8,400 diagnoses of early-stage colorectal cancer for U.S. seniors. While there was no distinguishable effect on breast cancer diagnoses, the authors state that lowering out-of-pocket spending for cancer screening would increase the chances of diagnosing cancer earlier and at a more treatable stage.

“It was likely critical that the cost sharing reduction for colorectal cancer screening was substantial and accompanied by incentives for patients to discuss preventive care with physicians,” they wrote.